Guideline Writers Have High Rates of Financial Conflicts, Study Says

Physicians with private financial conflicts of interest dominated some of the panels that wrote guidelines on cardiovascular health in recent years, according to a New York Timesarticle based on a study released yesterday in the Archives of Internal Medicine.

According to the study, conflicts of interest were reported by 56% of 498 people who helped write 17 guidelines for the American Heart Association and American College of Cardiology, from 2003 through 2008. Of people who led the guideline panels, an even higher rate (81%) had personal financial interests in companies affected by their guidelines.

In a joint statement, the cardiology and heart associations said that they had tightened their conflict-of-interest controls in 2010 to align with recommendations from the Council of Medical Specialty Societies. They now require that the people leading the group and a majority of members of any guideline-writing group be free of conflicts of interest. The groups also said their new policies were aligned with standards issued last week by the Institute of Medicine aimed at enhancing the quality and reliability of clinical practice guidelines, which include avoiding "intellectual, institutional, financial, or other forms of conflicts whenever possible."

The study's senior author said its most important finding may be that 44% of guideline writers had no financial interests in the area they reviewed. That rebuts the argument that there are not enough experienced experts who are independent, the Times says.